BMI 38 they want 40. is that IT for me...am i DONE?

[Successful4me 51]

Hello everybody...well, my doctor sent my referral off to the insurance company and they told me that i'm NOT a good candidate because my BMI is 38 and i need to be 40. is this normal insurance-speak and this is part of the game they play or am i just done? i really don't want to GAIN more weight to have this surgery, i'm already uncomfortable enough. i don't know if i keep having my doctor resubmit the application or just join weight watchers...again *sigh*. Any advice would be awesome. thank you.

My BMI was 36. I was denied & that same day I wrote Oxford a 2 page appeal letter pleading my case. I faxed a copy to them & also mailed it. 7 days later I was approved. You pay for your ins not the Doctors. You have to fight for what you truly believe. Go to the internet & type "appeal letters to insurance companies" it gives you several samples. Copy one or two then add your own truthful wording to it. The insurance companies want to hear from you, not only the requesting physician.

[Successful4me 51]

Hello everybody...well, my doctor sent my referral off to the insurance company and they told me that i'm NOT a good candidate because my BMI is 38 and i need to be 40. is this normal insurance-speak and this is part of the game they play or am i just done? i really don't want to GAIN more weight to have this surgery, i'm already uncomfortable enough. i don't know if i keep having my doctor resubmit the application or just join weight watchers...again *sigh*. Any advice would be awesome. thank you.

My BMI was 36. I was denied & that same day I wrote Oxford a 2 page appeal letter pleading my case. I faxed a copy to them & also mailed it. 7 days later I was approved. You pay for your ins not the Doctors. You have to fight for what you truly believe. Go to the internet & type "appeal letters to insurance companies" it gives you several samples. Copy one or two then add your own truthful wording to it. The insurance companies want to hear from you, not only the requesting physician.

Good luck

[Successful4me 51]

Hello everybody...well, my doctor sent my referral off to the insurance company and they told me that i'm NOT a good candidate because my BMI is 38 and i need to be 40. is this normal insurance-speak and this is part of the game they play or am i just done? i really don't want to GAIN more weight to have this surgery, i'm already uncomfortable enough. i don't know if i keep having my doctor resubmit the application or just join weight watchers...again *sigh*. Any advice would be awesome. thank you.

Your BMI does not have to be 40. New rules for 2014. There are several ins companies that changed this old fashioned rule.

[pink dahlia 2,513]

I was just barely a 40 bmi, but I had sleep apnea, high bp, and 1 other co morbibity, I just dont remember which one, and I was approved on the 1st try ! If you have to put a couple of small weights in your pockets and have your dr weigh you before he sends off your paperwork again. I hate to lie or cheat but sometimes you have to sway the info your way so you can get healthy !! I am SO glad I got banded, it brought me back to the healthy happy " me"!! Good luck !!

[Successful4me 51]

I was just barely a 40 bmi, but I had sleep apnea, high bp, and 1 other co morbibity, I just dont remember which one, and I was approved on the 1st try ! If you have to put a couple of small weights in your pockets and have your dr weigh you before he sends off your paperwork again. I hate to lie or cheat but sometimes you have to sway the info your way so you can get healthy !! I am SO glad I got banded, it brought me back to the healthy happy " me"!! Good luck !!

Congrats to you on ur new journey

[Skywalker 170]

Hello everybody...well, my doctor sent my referral off to the insurance company and they told me that i'm NOT a good candidate because my BMI is 38 and i need to be 40. is this normal insurance-speak and this is part of the game they play or am i just done? i really don't want to GAIN more weight to have this surgery, i'm already uncomfortable enough. i don't know if i keep having my doctor resubmit the application or just join weight watchers...again *sigh*.

Any advice would be awesome. thank you.

Wow that's ridiculous. It's like they want to you gain weight so you can start losing it. Sorry.

[valarie kk 103]

I'm extremely healthy - really no medical conditions other then weight. My doctor asked me if I had anything we could use, all I could come up with a weak bladder ( please don't let me sneeze, jump, or cough) he immediately said that will improve if you lose weight. Only took two weeks and I was approved. Don't give up keep fighting.

[Ms.Vickie 68]

Hello everybody...well, my doctor sent my referral off to the insurance company and they told me that i'm NOT a good candidate because my BMI is 38 and i need to be 40. is this normal insurance-speak and this is part of the game they play or am i just done? i really don't want to GAIN more weight to have this surgery, i'm already uncomfortable enough. i don't know if i keep having my doctor resubmit the application or just join weight watchers...again *sigh*.

Any advice would be awesome. thank you.

I understand you not wanting to gain more weight. But...here's my story...When I started researching Lap Band and my insurance company's requirements, I immediately knew what I had to do. I weighed 190 & my BMI was 38. No diabetes, no high blood pressure, no sleep apnea, but I had a history of asthma (no episodes in 3 years), so no real health problems. So since I'm really good at gaining weight, I did just that. Gained 10 lbs and BAM...surgery was approved.0

[SandyM 1,956]

You know when i first read this, i was like, "???? riiiiiiight!!! very funny!!" but actually, it makes TOTAL sense. i think my height is recorded at 5'5"... but i'm technically "5'4-1/2"...i probably COULD round down and that may make the difference. great idea!!! :-)

That's how I got past it. Your surgeons office should have helped with this

[Skywalker 170]

I weighed 190 & my BMI was 38.

You weighed 190? That seems like a good weight (all things considered). Do you mean 290?

[Ms.Vickie 68]

You weighed 190? That seems like a good weight (all things considered). Do you mean 290?

Yes I was 190 when I started. My heaviest weight was 222 and I am only 5 feet tall. Lol

[MestizaBander 43]

Yes I was 190 when I started. My heaviest weight was 222 and I am only 5 feet tall. Lol

I was the same way. Lol 190 and 5 ft tall. I have pcos and 5 herniated discs. My insurance approved the request 2 days after receiving it.